Transcript Living with Dying

Living with Dying
Theological and Practical Aspects
of End-of-Life Issues
Introduction
“I am leaving the land of the dying
living and will
soon be with the living.”
dying.”
Theological Aspects of
Living with Dying
A. The God-given Value of Human Life
“What is man that you are mindful of him, the son of man that you
care for him?” (Ps. 8:4)
“You made him a little lower than
the heavenly beings and crowned
him with glory and honor.”
(Ps. 8:5)
Theological Aspects of
Living with Dying
A. The God-given Value of Human Life
Theological Aspects of
Living with Dying
A. The God-given Value of Human Life
“There are no gods, no purposes, no
goal-directed forces of any kind. There
is no life after death. When I die, I am
absolutely certain I will be dead.
That’s the end of me. There is no
ultimate foundation for ethics, no
ultimate meaning to life.”
William B. Provine, Cornell University
Theological Aspects of
Living with Dying
B. The Christian View of Death
“The death of a man is, however, an infinite
and eternal misery and wrath.”
“We should be happy to die and desire
death. Death is only the narrow gate and
the small way to life.”
Theological Aspects of
Living with Dying
1. Death as Law
“We are consumed by your anger and terrified by your
indignation. You have set our iniquities before you, our
secret sins in the light of your presence. All our days
pass away under your wrath; we finish our years with a
moan.” (Ps. 90:7-9)
Theological Aspects of
Living with Dying
1. Death as Law
“Our death is a more terrible thing than all death not
only of other living beings, but also than the troubles
and death of other men. What of it when Epicurus dies?
He not only does not know that there is a God, but even
fails to understand his own misery and recognize the
disaster which he is experiencing. Christians, however,
and God-fearing men know that their death, together
with all the other miseries of this life, is to be equated
with God’s wrath.” (Martin Luther LW, 13, 112)
Theological Aspects of
Living with Dying
1. Death as Law
•Faced with difficulties, majority of older adults 60-100 –
•Kidney dialysis –
•AIDS –
LIFE!
LIFE!
•Quadriplegia –
LIFE!
LIFE!
Theological Aspects of
Living with Dying
2. Death as Gospel
“Where, O death is your victory? Where, O death, is your
sting? The sting of death is sin, and the power of sin is
the law. But thanks be to God! He gives us the victory
through our Lord Jesus Christ.” (1 Corinthians 15:55-57)
“In the midst of life, we are in death. In the midst of
death, we are in life.” (Luther LW 13,83)
Theological Issues of
Advance Directives
I am torn between the two: I desire
to depart and be with Christ, which is
better by far; but it is more necessary
for you that I remain in the body.
(Philippians 1:23-24)
Theological Aspects of
Living with Dying
C. The Theology of the Cross
“God shows that He is God precisely in the fact that
He is mighty in weakness, glorious in lowliness, living
and life-giving in death.”
(Paul Althaus. Theology of Martin Luther p. 34)
“The well organized campaign for legalized euthanasia cruelly
exploits the fear of suffering and the frustration felt when we
cannot restore to health those whom we love. Such fear and
frustration is genuine and deeply felt, especially with respect to
the aging. But to deal with suffering by eliminating those who
suffer is an evasion of moral duty and a great wrong.” (Always
to Care, Never to Kill)
God’s
love is at work even in our suffering.
Paul
Paul said
said ––“I“Irejoice
rejoice in
inmy
my_____________”
sufferings.”
Luther said – “Affliction
“ ___________
is the is
best
thebook
best in
book
my in
library.”
my library.”
C.H.
C.H.Spurgeon
Spurgeon said
said ––“I“Iventure
ventureto
tosay
saythat
thatthe
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greatestearthly
earthlyblessing
blessing that
thatGod
Godcan
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give to
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any
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ofus
usisishealth,
health,with the exception of sickness.”
Practical Aspects of
Living with Dying
Educate
About the Value of Life
Practical Aspects of
Living with Dying
Educate
About the Theology of the Cross
About Pain Control
About the “Right to Die” Movement
Practical Aspects of
Living with Dying
A Look at the Past:
Original Intent of the Movement
The Euthanasia Society of America (1938) hoped to “eventually
legalize the putting to death of non-volunteers beyond the help
of medical science.”
Nazi Germany
“It started with the acceptance of the attitude, basic in the
euthanasia movement, that there is such a thing as a life not
worthy of life.” (Dr. Leo Alexander, Psychiatrist and Chief
American Counsel at the Nurmberg Tribunal)
Verbal Engineering
“Verbal engineering must precede social engineering.” (Rita
Marker)
“Death with Dignity”
“Aid in Dying”
“Americans against Human Suffering”
“Compassion in Dying”
“Compassionate Relief of Suffering”
“Assisted
“Death
with
Suicide
Dignity
Act”
Act”
“Compassion
“Hemlock Society”
and Choices”
Practical Aspects of
Living with Dying
Educate
About the Theology of the Cross
About Pain Control
About Right to Kill Movement
About “Advance Directives”
Be Careful of What You Say!
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Advance Directive
An instrument in writing whereby
the person signing
the instrument, the principal,
provided direction in the document for future
health care decisions should that
person become unable to make their own
health care decisions.
Black’s Law Dictionary
Sixth Edition
Living Will
A document which governs the withholding or
withdrawal of life-sustaining treatment
from an individual in the event of an
incurable or irreversible condition that will
cause death within a relatively short time,
and when such person is no longer able to make
decisions regarding his or her medical treatment.
Living wills are permitted by statute in most states.
Black’s Law Dictionary
Sixth Edition
Health Care Power of Attorney
An instrument in writing whereby
one person, as principal, appoints another
as his agent and confers authority to perform
certain specified acts or kinds of acts
on behalf of the principal
regarding his health care only.
Black’s Law Dictionary
Sixth Edition
Living Wills
“Living Wills are deceptively named—they have little to do
with living and everything to do with dying. It is not wise
to sign a document which specifies conditions under which
one would rather be dead.” (Mary Senader, Human Life
Alliance)
“If we can get people to accept the removal of all treatment
and care, especially the removal of food and fluids, they will
see what a painful way this is to die, and then, in the patient’s
best interest, they will accept the lethal injection.” (Dr. Helga
Kuhse at a world conference of Right to Die Societies)
Living Wills Example 1

“If I should have an incurable or
arthritis
irreversible condition that will cause my
mental illness
death in a relatively short time…”
days, weeks, months, or years
Living Wills Example 2

“I direct my attending physician…”
whoever happens to be near…
Removes medical decisions
from your family
Living Wills Example 3

“Withhold or withdraw medical treatment
food and fluids
that only prolongs the dying process…”
South Dakota Living Will
LIVING WILL DECLARATION
TO MY FAMILY, PHYSICIANS, AND ALL
THOSE CONCERNED WITH MY CARE:
I, _________, willfully and voluntarily make
this declaration as a directive to be
followed if I am in a terminal condition
and become unable to participate in
decisions regarding my medical care.
With respect to any life-sustaining
treatment, I direct the following:
(Initial only one of the following optional
directives if you agree. If you do not agree
with any of the following directives, space
is provided below for you to write your
own directives).
NO LIFE-SUSTAINING TREATMENT. I
direct that no life-sustaining treatment be
provided. If life-sustaining treatment is
begun, terminate it.
TREATMENT FOR RESTORATION. Provide
life- sustaining treatment only if and for so
long as you believe treatment offers a
reasonable possibility of restoring to me
the ability to think and act for myself.
TREAT UNLESS PERMANENTLY UNCONSCIOUS.
If you believe that I am permanently
unconscious and are satisfied that this
condition is irreversible, then do not provide me
with life-sustaining treatment, and if lifesustaining treatment is being provided to me,
terminate it. If and so long as you believe that
treatment has a reasonable possibility of
restoring consciousness to me, then provide
life-sustaining treatment.

MAXIMUM TREATMENT. Preserve my life
as long as possible, but do not provide
treatment that is not in accordance with
accepted medical standards as then in
effect.
With respect to artificial nutrition and hydration,
I wish to make clear that
(Initial only one)
_________ I intend to include this treatment
among the "life-sustaining treatment" that may
be withheld or withdrawn.
_________ I do not intend to include this
treatment among the "life-sustaining
treatment" that may be withheld or withdrawn.
(If you do not agree with any of the
printed directives and want to write your
own, or if you want to write directives in
addition to the printed provisions, or if you
want to express some of your other
thoughts, you can do so here.)
What If I Have a Living Will?




Do you know what it says?
Contact your attorney
They are revocable
Start over
Health Care Power of Attorney

Designate someone you trust




More than one person
Share values about the sanctity of life
Discuss your wishes
Do not be too specific
Refusing Medical Treatment

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

Right to refuse treatment
Does not sustain life,
but prolongs the dying process
Discuss if treatment is a burden
“Right to die” – patient is a burden
“Once we have transgressed and blurred the line between
killing and allowing to die, it will be exceedingly difficult—
in logic, law, and practice—to limit the license to kill.
Once the judgment is not about the worth of specific
treatments but about the worth of specific lives,
our nursing homes and other institutions will present us
with countless candidates for elimination who would
‘be better off dead.’”
Always to Care, Never to Kill: A Declaration on Euthanasia
by the Ramsey Colloquium as published in First Things February 1992:45-47
Terri Schiavo
“If she is a living human being, albeit a
severely disabled one, then our
responsibility
askshould
what we can do
We was
can to
and
to benefit
the life
had.toIt’s
not within
allow
theshe
dying
die.
the scope
ofmust
our authority
to ask whether
We
never intend
it’s a benefit
to
have
her
life.”
for the death of the
Dr. Gilbert Meilaender – member of the President’s Council on
Bioethics and Professorliving.
of ethics at Valparaiso University.
Terri Schiavo was not dying. Removing her
feeding tube did not allow her to die. It caused
her to die.
Focus on the treatment
• Is it useless?
• Is it excessively burdensome?
Focus on the person
• Is he/she useless?
Is he/she dying?
• Is he/she burdensome?
The Slippery Slope
Right to refuse treatment
“Right to die”
Right to assisted death
(physician-assisted suicide)
“Duty to die”
Euthanasia
(“Right to kill”)
A Glimpse of the Future:
“The Netherlands has moved from assisted suicide to euthanasia,
from euthanasia for people who are terminally ill to euthanasia for
those who are chronically ill, from euthanasia for physical illness to
euthanasia for psychological distress, and from voluntary
euthanasia to involuntary euthanasia (called ‘termination of the
patient without explicit request.’) There is no way to stop the slide
once a society steps onto the slippery slope by legalizing physicianassisted suicide.” (Dr. Herbert Hendin, 1996 report to Judiciary
Committee of House)
Practical Aspects of
Living with Dying
Caring for and about
“I have participated in the intensely human drama that surrounds
dying. I’ve witnessed the difficulties, I’ve smelled the odors, I’ve
seen the unpleasant liquids which assisted suicide advocates
claim make life at the end inherently undignified, horrific, and
hence worthy of a death sentence. Yet, such conditions need not
diminish the inherent value of human life. Dying people remain
people, and when properly treated, they usually transcend the
limitations of their physical conditions—especially if they know
they are cared for and about.” (Hospice Worker)
Concluding Parable
There was an old woman
who lived in the woods.
Great Theology Makes
Great Practical Care
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We know the root cause of pain and
suffering.
We know the cure for that root cause.
We know that pain and suffering will be
part of this life.
We know about God’s presence in
suffering.
We know where we are going.
Questions
?????
Recommend Resources

Protective Medical Decisions Document
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Will to Live

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International Task Force
on Assisted Suicide and Euthanasia
National Right to Life Committee
Durable Power of Attorney:
Christian Version

Christian Life Resources
Brochures from LFL
Basics on
Advance
Directives
Brochures from LFL

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God’s Love in Human Suffering
Euthanasia and the Christian
A Guide for Christians
in Ethical Decision-Making at
the End of Life
Brochures from LFL
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God’s Love in Human Suffering
Euthanasia and the Christian
A Guide for Christians
in Ethical Decision-Making at
the End of Life
The Right to Die:
Rhetoric, Reality, Response
Before I Die